Difficult Airway Algorithm and Rescue Cricothyrotomy using the Vortex Approach

The goal of the DAARC program is to improve the recognition of an anticipated emergent airway and the early identification of a cannot intubate, cannot ventilate situation. The focus of the training is to manage difficult airways using the Vortex Approach and implement the scalpel, spreader, and bougie open surgical cricothyrotomy technique. The Vortex approach is a cognitive aid to be used when making decisions while in a high risk and high stress difficult airway management situation.

Video Timeline:
00:00 – 00:28 Introduction message stating presentation is for training purposes only
00:36 – 01:03 Statement of training goal
01:04 – 01:22 Learning objectives
01:24 – 06:33 06:33 Front of neck surgical access
07:09 – 09:58 Introduction to the Vortex approach
09:59 – 10:38 Summary

Practice Scenario A: Mr. Damon Jones

Mr. Damon Jones is a 32-year-old man who was brought in by the police, combative and non-cooperative. It appears he was involved in some sort of assault trauma and he might have a separated shoulder. Patient is to combative to be assessed and most likely will need rapid sequence intubation.

Practice Scenario B: Mr. Javier McBride

Mr. Javier McBride is a 54-year-old male with a past medical history of hypertension, Hodgkin's lymphoma, and coronary artery disease with an injection fraction of 35%. He's obese with diabetes mellitus and has pneumonia. His Cri Con is probably in the yellow to red range and he is going to be a very difficult intubation.

Practice Scenario C: Mrs. Angela Scott

Mrs. Angela Scott is a 65-year-old female. She has a history of third degree burns to her face, about 20 years ago. The patient currently has severe pneumonia and is pending respiratory failure. As a result of her previous injuries, she has a limited oral airway opening, and the concern is how to maintain her airway. This video demonstrates the one hand and two hand Bag Value Mask (BVM) technique.

Practice Scenario D: Mr. Nathan Clark

Mr. Nathan Clark is a 70-year-old who has a small bowel obstruction. His has a medical history of hypertension, hyperlipidemia and coronary artery disease. He got an abdominal pelvic CT with contrast. He has no previous allergy to contrast medium. He's sitting up in bed, retracting, and wheezing. He has significant facial edema on his face and arms. His Cri Con is in the red range.

Downloadable Audio Podcasts

Often, trying to watch a presentation or instructive video while practicing the techniques is challenging. It is because of this, that we are happy to provide audio podcasts for your convenience.

In order to download any of these files, click the download button and then choose to download the file from your browser player, or right click any of the download buttons, then select "Save Target As..." and identifying a location on your personal computer. From that point, you may transfer these .mp3 audio files to a portable MP3 player or a compatible phone.

Podcast 1: Game Scenario 2: Javier McBride

Mr. Javier McBride is an obese 54-year-old male. He has a past medical history of hypertension, coronary artery disease, and diabetes mellitus. Patient has probable pneumonia and is experiencing acute respiratory distress.
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Podcast 2: Game Scenario 3: Angela Scott

Mrs. Angela Scott is a 65-year-old female. She has a history of third-degree burns to her face, about 20 years ago. Patient currently has severe pneumonia with a large infiltrate and is pending respiratory failure.
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Podcast 3: Game Scenario 4: Nathaniel Clarke

Mr. Nathaniel Clarke is a 70-year-old male. He has a medical history of hypertension, hyperlipidemia, and coronary artery disease. He presented with a small bowel obstruction and just returned from radiology. He’s experiencing a delayed anaphylactic reaction to contrast with itching, a rash, and is wheezing.
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